Q&A: Help, I Missed the Medicare AEP Deadline!

Posted on Posted in Medicare, Part C Medicare Advantage, Part D Precription Drug, Prescription Drug Plan, Uncategorized

This year’s Medicare October 15 through December 7 AEP (Annual Enrollment Period) was a busy time for me and I’m grateful for the scores of individuals and couples who permitted me to help with their 2018 Medicare Supplement, Medicare Advantage or Part D Prescription drug plan selection. Still, as I am fielding calls for help after the deadline this is a good time to share some Q&As in case you, a neighbor or family member missed that deadline:

Q: I missed the deadline to make a change. Is there another option, or extension period, for me to choose a new plan for 2018?
A: Maybe. Some Medicare participants are eligible for what’s called a Special Election Period during which you can make a change to your Part D prescription drug or Medicare Advantage Plan outside of the October 15 – December 7 Annual Enrollment Period.

Q: Am I eligible for this Special Election Period?
A: Possibly. You may belong to one of two groups that have this Special Election Period; New York State EPIC or Social Security Extra Help.

1) Medicare participants enrolled in a State Pharmaceutical Assistance program (SPAP) have one Special Election period per calendar year. The New York State SPAP is called EPIC.
2) Medicare participants enrolled in the Part D Extra Help program have the Special Election Period benefit, too.

Q: Sounds great, Dan. What special circumstances are required for me to take advantage of this Special Election Period?
A: There doesn’t have to be a specific reason. Still, the two most common situations I see are:

1) HMO Restrictions: An individual realizes their Medicare Advantage plan is a HMO plan with restrictions on seeing doctors outside of the HMO network and wants, instead, to join a PPO or Medigap / Supplement plan which allows you to see any doctor accepting Medicare. (Be sure to listen to Bob’s HMO story – click on the Monopoly Man(TM) card below.)
2) Many individuals receiving Social Security Extra Help become aware there are plans where the Extra Help subsidy could reduce their monthly premium to $0.
Use Medicare Special Election Period to Change Medicare Advantage Plan Click on Monopoly Man(TM) and listen to my short interview with Bob Foxworth. Bob used his Special Election period to change plans after his HMO refused approval to see a cancer specialist of his choice.

Q:  I’m not sure of my eligibility status, Dan; can you help me with my questions?
A: Yes, just call me at (518) 346-2115 or send me a note below and we’ll discuss your options by telephone, web conference or in person visit. And, during this Special Election Period, we may be able to identify a Medicare Advantage, Medigap or Prescription Drug Plan more suited to your needs – even though the December 7 deadline has passed.







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